Medical tourism industry suffers as health insurance companies stop paying some bills

Health insurance - Medical Tourism

Insurers have begun excluding certain procedures for patients out of the country.

American health insurance companies have started placing a limit on the procedures they will cover for patients traveling to other countries to get them.

Patients had been traveling to cities such as Tijuana to receive their medical procedures.

According to the Tijuana Convention and Tourism Committee, medical tourism has plummeted as US health insurance companies have started limiting the procedures their policyholders are covered for outside the country.

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The new regulations implemented by the insurers are impacting both Tijuana’s medical industry and patients from the United States, said the director of Tijuana’s Convention and Tourism Juan Coronado Ruiz.

“Bariatric procedures, for example, are down by 50 percent,” said Coronado Ruiz. “This is something that harms everyone, insurance companies don’t want to cover anything on the Mexico side of the border and that’s why people are aren’t visiting.”

Why did health insurance companies make the change?

Coronado Ruiz has placed the motivation of insurers into question.  He underscored the impact the limitations on covered procedures will have on both the medical industry of Tijuana and on patients who want to travel for their procedures.

“Since the second half of 2023, medical tourism has dropped between 30 and 80 percent,” he explained. “There are still people coming for surgeries, consults and prescriptions, but not like before.”

Expensive procedures

According to Coronado Ruiz, there are some patients who are able to pay for certain medical procedures in cash. However, the majority of people require coverage from their health insurance companies in order to be able to afford complicated major surgeries. That said, insurers aren’t paying for those procedures out of the country anymore.

Impact on the broader economy as health insurance companies change coverage.

The change in medical tourism is leading to changes in much broader areas of the local economy. For instance, without people visiting the area for their medical procedures, there has been a drop in reservations at hotels, and restaurants aren’t seeing the number of diners who require meals due to their medical stays in the area.

“Many patients stay here for several days when they have procedures, and some would rather recuperate in a hotel setting under supervision,” said Coronado Ruiz.

Hotels, restaurants and other companies are now trying to develop new strategies amid the drop in medical tourism.

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